| NPI | 1629605019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MO 2022017866) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 37190) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2022-05-23 |